Lewiston Office:
5320 Military Road * Suite 104
Lewiston, NY 14092 (on Mt. St. Mary's campus)
Kenmore Office:
2780 Delaware Ave * Suite 202
Kenmore, NY 14217(at rear of building 2760/70)
East Amherst Office:
6105 Transit Road * Suite 100/120
East Amherst, NY 14051
ACNE
Acne is an inflammatory condition of hair follicles that is prompted by occlusion (clogging) of pores. Treatments are thus directed at opening the pores and controlling the inflammation. Acne is stimulated at puberty when increased oil production occurs under hormonal influence (particularly androgens such as testosterone). Oil leads to occlusion and is a source of nutrients for bacteria that live on the skin. When the bacteria feed on the oil they break it down into factors that cause inflammatory cells to migrate into the follicle. Understanding these processes will help you understand the basics of acne treatment.
Treatments for follicular occlusion (clogged pores). Follicular occlusion leads to whiteheads and blackheads. Factors affecting this include oil production and a build up of dead skin cells around the opening of the follicle (the pore). Treatments include keratolytics that break up these dead skin cells such as the common over-the-counter treatments benzoyl peroxide, salicylic acid, and glycolyic acid. Treatments that break up oil include various cleansers. The gold standard for treating follicular occlusion are the Vitamin A-derived topicals called retinoids. Retinoids both decrease oil production and decrease the stickiness of dead skin cells around the pore. Retinoids can be either over-the-counter topicals such as adapalene 0.1% or prescription topicals such as higher strength adapalene, tretinoin or tazarotene.
Treatments for inflammation. Anti-inflammatory strategies include antibiotics to decrease bacterial presence on the skin as well as products that work directly to inhibit inflammatory pathways. Antibiotic therapies include many topicals such as the facial cleansers as well as benzoyl peroxide; prescription topical antibiotics include clindamycin, erythromycin, and azelaic acid. Products that inhibit inflammation directly include the prescription topical dapsone. When inflammation is severe, oral antibiotics are often considered. The most common class of oral antibiotics is the tetracycline family which includes doxycycline and minocycline; tetracyclines are both anti-bacterial and have an ability to inhibit inflammatory pathways directly.
Severe cases of acne: In cases in which the standard therapies have failed to control the severest form of acne (nodulocystic), isotretinoin, an oral retinoid commonly known by its previous brand name Accutane, can be considered. Because of the many potential side effects of this medication, this drug should only be prescribed by the professionals in a dermatology office.
Other strategies:
spironolactone and certain oral contraceptives (OCPs) for women: these reduce levels of pro-acne testosterone; these agents are particularly helpful for women who have acne in the beard area and who have pre-menstrual flares
photodynamic therapy (PDT) (Blu-U): PDT can decrease oil production in the skin and appears to kill bacteria as well; it is used for moderate to severe acne
As always, you can contact our office to answer any questions or concerns.
Psoriasis is a skin condition that creates red patches of skin with white, flaky scales. It most commonly occurs on the elbows, knees and trunk, but can appear anywhere on the body. The first episode usually strikes between the ages of 15 and 35. It is a chronic condition that will then cycle through flare-ups and remissions throughout the rest of the patient's life. Psoriasis affects as many as 7.5 million people in the United States. About 20,000 children under age 10 have been diagnosed with psoriasis.
In normal skin, skin cells live for about 28 days and then are shed from the outermost layer of the skin. With psoriasis, the immune system sends a faulty signal which speeds up the growth cycle of skin cells. Skin cells mature in a matter of 3 to 6 days. The pace is so rapid that the body is unable to shed the dead cells, and patches of raised red skin covered by scaly, white flakes form on the skin.
Psoriasis is a genetic disease (it runs in families), but is not contagious. There is no known cure or method of prevention. Treatment aims to minimize the symptoms and speed healing.
There are five distinct types of psoriasis:
People who have psoriasis are at greater risk for contracting other health problems, such as heart disease, inflammatory bowel disease and diabetes. It has also been linked to a higher incidence of cardiovascular disease, hypertension, cancer, depression, obesity and other immune-related conditions.
Psoriasis triggers are specific to each person. Some common triggers include stress, injury to the skin, medication allergies, diet and weather.
Psoriasis is classified as Mild to Moderate when it covers 3% to 10% of the body and Moderate to Severe when it covers more than 10% of the body. The severity of the disease impacts the choice of treatments.
Mild to moderate psoriasis can generally be treated at home using a combination of three key strategies: over-the-counter medications, prescription topical treatments and light therapy/phototherapy.
The U.S. Food and Drug Administration has approved of two active ingredients for the treatment of psoriasis: salicylic acid, which works by causing the outer layer to shed, and coal tar, which slows the rapid growth of cells. Other over-the-counter treatments include:
Prescription topicals focus on slowing down the growth of skin cells and reducing any inflammation. They include:
Controlled exposure of skin to ultraviolet light has been a successful treatment for some forms of psoriasis. Three primary light sources are used:
Treatments for moderate to severe psoriasis include prescription medications, biologics and light therapy/phototherapy.
Oral medications. This includes acitretin, cyclosporine and methotrexate. Your doctor will recommend the best oral medication based on the location, type and severity of your condition.
Biologics. A new classification of injectable drugs, biologics are designed to suppress the immune system. These tend to be very expensive and have many side effects, so they are generally reserved for the most severe cases.
Light Therapy/Phototherapy. Controlled exposure of skin to ultraviolet light has been a successful treatment for some forms of psoriasis. Two primary light sources are used:
Questions or Comments?
We encourage you to contact us whenever you have an interest about our services.
5320 Military Road Suite 104
Lewiston, NY 14092 (Main office)